Utility of High-Resolution Sonography for Evaluation of Knee Joint Pathologies as a Screening Tool

Singh, Atul Pratap; Chandak, Shruti; Agarwal, Arjit; Malhotra, Amber; Jain, Ashwani; Khan, Adil Ali

doi:10.1177/87564793211035773

Cited by 6 publications

(15 citation statements)

References 25 publications

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“…In sensitivity analysis, the pooled results of diagnostic accuracy were found to be robust (AUC 0.97 95% CI 0.83–0.97) after removing two small-sample studies (number of patients < 30) [ 18 , 26 ], but the level of heterogeneity remained high. After removing four studies involving a high risk of bias [ 19 , 20 , 25 , 31 ], the pooled results of diagnostic accuracy were still robust (AUC 0.98 95% CI 0.76–1.00) and the heterogeneity of AUC was significantly reduced, with the I 2 index decreasing from 87 to 22%. The study quality assessed by QUADAS-2 may influence the degree of heterogeneity among the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…First, a high degree of heterogeneity was detected among the included studies, so that a bivariate model was adopted in our meta-analysis to incorporate the uncertainties arising from between study variations. Second, this meta-analysis included a limited number of studies, with only three studies involving 100 participants or more [ 19 , 28 , 30 ]. Given the limited number of larger studies included, more primary research is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography is a rapid, portable, widely available, inexpensive and noninvasive imaging modality that has been proposed as a promising imaging tool for the assessment of BC [ 15 , 18 , 19 ]. However, a general view is that ultrasound is not as accurate as MRI in diagnosing BC (absent or present) [ 19 , 20 ]. Currently, there are no published systematic investigations regarding the diagnostic accuracy of ultrasound for BC.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

Liu

Li²,

Weng³

et al. 2022

J Orthop Surg Res

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Background Baker’s cyst is the most common cystic disease of the knee, and a fast and accurate diagnosis of Baker’s cyst is essential for a better management. Ultrasound is a rapid, portable, widely available, inexpensive and noninvasive imaging modality. However, the diagnostic accuracy of ultrasound on Baker’s cyst still remains undetermined. We conducted the first meta-analysis to comprehensively assess the accuracy of ultrasound for the detection of Baker’s cyst. Methods PubMed, Embase and Web of Science were searched from inception to July 14, 2022, without language restrictions. Studies providing cross-tabulations of ultrasound versus pathology (gold standard) or MRI (standard imaging technique) for diagnosis of Baker’s cyst were included. Indicators for the diagnostic accuracy of ultrasound, including sensitivity, specificity and area under the curve, were calculated using a bivariate model. Sensitivity analysis was conducted to evaluate the heterogeneity and robustness of the results. Results A total of 13 studies with 1,011 subjects (mean age 32.2 years; men 53.5%) met the inclusion criteria. The pooled sensitivity, specificity and area under the curve of ultrasound for diagnosis of Baker’s cyst, compared with pathology, were 0.97 (95% confidence intervals: 0.73–1.00), 1.00 (0.98–1.00) and 1.00 (0.99–1.00), respectively. The pooled estimates of ultrasound versus MRI were 0.94 (0.87–0.98) for sensitivity, 1.00 (0.83–1.00) for specificity and 0.97 (0.95–0.98) for area under the curve. Sensitivity analysis did not change the results materially. Conclusion Ultrasound shows excellent diagnostic accuracy for the assessment of Baker’s cyst and provides similar diagnostic information (absent or present) compared to MRI. Because of its advantages of low cost, portability and accessibility, ultrasound is likely to be a choice of imaging technique for screening Baker’s cyst in clinical and population settings as well as in follow-ups.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

Liu

Li²,

Weng³

et al. 2022

J Orthop Surg Res

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“…Lastly, POCUS allows for rapid interpretation that can save patients trepidation while awaiting advanced imaging for a definitive diagnosis and improve overall patient satisfaction. An added benefit of POCUS is the evaluation of concomitant pathology and secondary signs that are highly suggestive of ACL tears (13,27,28).…”

Section: Role Of Ultrasound For Augmenting Clinical Carementioning

confidence: 99%

“…It is worth mentioning that the PLUS is not meant to replace MRI, which remains the standard imaging modality for internal derangement of the knee. However, recent evidence suggests that diagnostic accuracy of MSKUS can be comparable to MRI for various knee injuries aside from the ACL (13,34). Considering the various pathologies that mimic ACL tears, the PLUS can serve as a point-of-care screening tool for earlier diagnosis and management of ACL injuries to allow for more judicious use of MRI, especially when MRI is unavailable or contraindicated.…”

Section: Limitations Of the Plus Techniquementioning

confidence: 99%

Prone Lachman with Ultrasound: A Literature Review and Description of the Technique

Raja

Meyer

Tunis

et al. 2022

Curr Sports Med Rep

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Magnetic resonance imaging is the current gold standard imaging modality for diagnosing anterior cruciate ligament (ACL) tears. However, ultrasound has grown in popularity for detecting ACL injuries because of its low cost, portability, and dynamic assessment capabilities. Recent studies demonstrate high sensitivity and specificity for diagnosing isolated ACL tears via ultrasound, but tremendous heterogeneity remains for optimal technique including patient positioning, transducer placement, and dynamic versus static ultrasound usage. As ultrasound becomes ubiquitous in clinics, training rooms, and on the sidelines, identifying objective and sensitive measurements to appropriately screen athletes for significant knee injuries is imperative. This article aims to review the current role of diagnostic ultrasound in ACL injuries and propose a standardized version of the Prone Lachman with Ultrasound test, which is an objective, reliable, and easily reproducible technique to evaluate ACL competency. Developing a standardized protocol will expand the use of point-of-care ultrasound, which may reduce cost and improve efficiency in care.

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Diagnostic Accuracy of Ultrasound for Assessment of Synovial Abnormalities Among Patients With Knee Pain: A Meta‐Analysis

Liu

Weng

et al. 2023

Arthritis Care & Research

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ObjectiveSynovial abnormalities, which are modifiable treatment targets for knee pain, affect approximately 25% of adults. Ultrasound is a safe, inexpensive and easily‐accessible imaging modality for assessing synovial abnormalities, but its diagnostic accuracy is still controversial. We conducted a meta‐analysis by comparing ultrasound with the “reference standard” method, i.e., magnetic resonance imaging (MRI), in assessing synovial abnormalities among patients with knee pain.MethodsPubMed, Embase, and Web of Science were searched from inception to January 7, 2022 to retrieve studies including patients with knee pain for evaluating: 1) the diagnostic accuracy of ultrasound versus MRI for synovial abnormalities (synovitis and synovial effusion), and 2) the correlations of synovial abnormalities assessed by ultrasound and MRI. The summary of diagnostic accuracy was analysed using the bivariate model, and the correlation coefficients were pooled using the random effects model.ResultsFourteen studies were included, representing a total of 755 patients. The pooled sensitivity, specificity and area under the curve were 0.88 (95% confidence interval [CI]:0.65‐0.96), 0.70 (95%CI:0.51‐0.84) and 0.81 (95%CI:0.77‐0.84) for synovitis, and were 0.90 (95%CI:0.81‐0.95), 0.86 (95%CI:0.77‐0.92) and 0.94 (95%CI:0.91‐0.96) for synovial effusion, respectively. Strong correlations between ultrasound‐ and MRI‐diagnosed synovitis (r=0.64, 95%CI:0.56‐0.71) and synovial effusion (r=0.63, 95%CI:0.52‐0.73) were observed.ConclusionUltrasound demonstrated a promising accuracy in detecting synovial abnormalities among patients with knee pain. The use of ultrasound provides equivalent synovial information to MRI but is less expensive and more accessible. Therefore, it is recommended as an adjuvant for managing patients with knee pain during diagnostic strategy and individualized treatment decision‐making.This article is protected by copyright. All rights reserved.

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Utility of High-Resolution Sonography for Evaluation of Knee Joint Pathologies as a Screening Tool

Cited by 6 publications

References 25 publications

Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

Diagnostic accuracy of ultrasound for the assessment of Baker’s cysts: a meta-analysis

Prone Lachman with Ultrasound: A Literature Review and Description of the Technique

Diagnostic Accuracy of Ultrasound for Assessment of Synovial Abnormalities Among Patients With Knee Pain: A Meta‐Analysis

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